It is estimated that one in five women between the ages of 18 and 45 who seek care in primary care medical settings experience domestic violence. There are numerous guidelines from national medical associations that promote routine screening and intervention, and there is great public interest in this topic. But there is little evidence on how effectively care meets the needs of women experiencing domestic violence. This has led the U.S. Preventive Services Task Force to conclude that there is insufficient information to either recommend or to oppose universal screening for domestic violence in medical settings. The project goals are to: (1) investigate the effectiveness of domestic violence intervention components; (2) establish a methodology to define outcome measures for domestic violence interventions that incorporate patient, community, and expert viewpoints; (3) explore the feasibility of monitoring these outcomes measures in this population with a longitudinal cohort study; (4) based on outcomes of the first three goals, create a methodology for a cost-benefit analysis of domestic violence interventions; and (5) use the results of this project as the basis for an R01 application to investigate the cost-effectiveness of primary care-based domestic violence interventions in a controlled clinical trial. Accomplishment of goal five will provide the foundation for the candidate's career development as an independent investigator. How can we best investigate the effectiveness of domestic violence interventions in primary care? The overall study design consists of several components, integrated to design an informed, cost-effective analysis of domestic violence interventions in primary care. These components of the intervention are: (1) a pretest-post test, quasi-experimental investigation of six components of a domestic violence intervention; (2) a mini-conference to define patient outcome measures; (3) a pilot test of the feasibility of administering outcome measures; (4) a descriptive cohort study of women receiving domestic violence services, including qualitative interviews; and (5) the development of a cost-effectiveness methodology. Constructs for patient outcome measures are: (1) domestic violence severity; (2) psychological sequelae; (3) quality of life; (4) correlates of well being; (5) health care utilization; and (6) costs. Process measures will determine whether abused women received appropriate care according to the intervention protocol. This study will provide essential, timely information to guide the medical community on how best to respond to develop domestic violence interventions and investigations on cost-effectiveness of domestic violence interventions in primary care.